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The selection of your health care practitioner is one of the most important decisions you make when you are dealing with menopause. Remember, you are a trained consumer; you comparison shop every time you go to the supermarket. When you are about to buy a car or an appliance, you've already done your homework, that is, you have asked many questions before you made your decision. The process of selecting a health care practitioner is no different.
Health care practitioners provide a service to you -- you are the consumer. Do not be intimidated by their credentials. Health care practitioners are only human, like you and me.

You may choose a medical doctor, a nurse practitioner, a homeopathic doctor (the Royal Family in England consults with homeopathic physicians), a nutritionist, an acupuncturist, a herbalist, a therapist, or a combination of these resources. To help you make a decision, ask the following questions:

Are they knowledgeable about the menopause transition? A health care practitioner primarily experienced in child birth may not be as helpful about menopause and aging.

What is your health care practitioner's training in menopause and in aging?

What classes on menopause and on aging have they attended or taught recently? You want a health care practitioner who keeps current.

How much time does your health care practitioner spend with you? You will need time to fine tune your program over a period of time.

Is your health care practitioner readily available? Having to wait for a month or more to see someone may not help you.

Can you talk with your health care practitioner openly as an equal? How does he or she respond to your questions? If a health care practitioner gets upset when you question his or her information, put on your "boots made for walking."

Is your health care practitioner aware of alternative therapies or natural methods? Is she or he open to these alternatives?

Is your health care practitioner willing to confer with other professionals on alternative treatments?

Does your health care practitioner listen closely to you to find out about your lifestyle in terms of diet, exercise and sexual activity? Does he or she make a practice of learning about your family history?

Does your health care practitioner explain things in a way you can understand?

Does your health care practitioner review the pros and cons of ERT (Estrogen Replacement Therapy) and HRT (Hormone Replacement Therapy)? Does he or she talk about the side-effects of synthetic forms of estrogen and progesterone, and does he or she give you information about synthetic testosterone vs. its natural forms?

Does your health care provider give you information to help increase your knowledge about menopause?

What type of ongoing support and classes does your health care provider offer? And if he or she offers no such classes, can he or she refer you to such classes?

Remember, you are a knowledgeable woman and it's your body. Make sure that your health care practitioner doesn't lump all your symptoms into the category of *menopause* or that of aging. Some illnesses can cause symptoms similar to menopause, like my heavy bleeding which was caused by fibroids. Keep asking questions until you get the answers.

Ellen had been taking synthetic estrogen for over 10 years without any problems. Then, a few years ago she started to notice physical and emotional changes. She couldn't figure out what was going on. She saw many doctors, and still she became extremely ill. Finally one doctor diagnosed that she had gall stones, which are a well-known potential side-effect of taking synthetic estrogen. Her persistence saved her life.

A friend, Nancy, at age 36, also noticed physical and emotional changes. She went from physician to physician, but found no answers and no relief. A dozen physicians told her there was nothing wrong with her, medically. One even recommended that she see a psychiatrist, since "it had to have been in her head." Nancy knew that this wasn't true, but after so many physicians and tests she was questioning herself. Luckily, Nancy heard about another
*good* gynecologist and decided to try one more time. The first thing this doctor did was to test her hormone levels. And guess what? Nancy was peri-menopausal. After years of searching (I met her when she was 42), finally she had an answer. Within a few months of HRT, her problems disappeared. She could have avoided years of suffering if any of the other doctors had thought of checking her hormone levels.

Certainly, I believe in consulting with a psychiatrist or therapist; otherwise, I would not do what I do professionally. I believe that it is important to look at all aspects of a person. A psychiatrist I know asks that complete hormonal, vitamin, and mineral tests be done on her patients before she will work with them. She has found many "emotional problems" are actually nutritional deficiencies and/or imbalances. When I work with clients on sexual enhancement, I always suggest they have themselves examined for physical and nutritional problems. The mind and the body are not separate from each other.

Another friend, Cindy, had extremely heavy night sweats during her period. Her physician put her on ERT, but that didn't work. Then he put her on medication that contained a tranquilizer without even informing her. When I talked with Cindy, I asked her about her sugar, coffee and wine consumption, something her physician never did. I gave her some charts and suggested she keep track of what she ate and drank during her heavy night sweats. Armed
with new knowledge, she could take charge of her situation and therefore, feel better. I also suggested that she review this information with her physician, and that she become actively involved in her health care.

I don't know the answers for you. Only you and your health care practitioner can answer the questions about what is best for you. However, even to ask the questions, you need to know more, such as your family's health history, your personal health history, and also what is happening to you currently.

Is the menopause transition confusing? Yes! Necessary? It is inevitable! Is taking charge important? Yes! This is your change, as well as the beginning of the rest of your life. Consider this change a great opportunity.